Title:Beta-Blockers and Nitrates: Pharmacotherapy and Indications
Volume: 13
Issue: 1
Author(s): Emanuela Facchini, Anna Degiovanni, Chiara Cavallino, Alessandro Lupi, Andrea Rognoni and Angelo S. Bongo
Affiliation:
Keywords:
Angina pectoris, beta-blockers, nitrates, pharmacotherapy, stable angina, vasodilator affect.
Abstract: Many clinically important differences exist between beta blockers. B1-selectivity is of
clinical interest because at clinically used doses, b1- selective agents block cardiac b-receptors while
having minor effects on bronchial and vascular b-receptors. Beta-adrenergic blocking agents
significantly decrease the frequency and duration of angina pectoris, instead the prognostic benefit of
beta-blockers in stable angina has been extrapolated from studies of post myocardial infarction but
has not yet been documented without left ventricular disfunction or previous myocardial infarction.
Organic nitrates are among the oldest drugs, but they still remain a widely used adjuvant in the treatment of symptomatic
coronary artery disease. While their efficacy in relieving angina pectoris symptoms in acute settings and in preventing
angina before physical or emotional stress is undisputed, the chronic use of nitrates has been associated with potentially
important side effects such as tolerance and endothelial dysfunction. B-blockers are the firstline anti-anginal therapy in
stable stable angina patients without contraindications, while nitrates are the secondline anti-anginal therapy. Despite 150
years of clinical practice, they remain fascinating drugs, which in a chronic setting still deserve investigation. This review
evaluated pharmacotherapy and indications of Beta-blockers and nitrates in stable angina.
